Age and frailty as risk factors for the development of osteoarthritis.

Osteoarthritis (OA) is a degenerative joint disease that increases in prevalence with advanced age. While a multitude of factors contribute to the development of OA, ageing has been implicated as a major driving force leading to an inability of the joint to repair itself and maintain normal health. In aged individuals, changes in joint cellular composition and signalling mechanisms have been observed which could lead to the development of degenerative joint disease. Senescent cells found in both aged and OA joints release senescent-associated mediators which can destroy articular tissues. These changes in addition to the chronic pro-inflammatory environment associated with ageing may hinder the ability of the joint to repair culminating in OA. We hypothesise that frailty may also drive OA development by creating an inflammatory environment that can interfere with normal tissue health. The molecular and biochemical changes associated with OA may in turn promote frailty resulting in an exorable deterioration of the joint. Frailty may therefore be considered an additional risk factor for the development of OA.